DMS

Skin Immunology
Ageng Brahmadhi

Integumentum layers

Functions

Protection against injury, bacterial

invasion, and desiccation

Regulation of body temperature

Reception of continual sensations from the

environment (e.g., touch, temperature, and

pain
Excretion from sweat glands
Absorption of ultraviolet radiation from the
sun for the synthesis of vitamin D.

Epidermis

Mainly composed by Stratified squamous keratinized

epithelium

another cells population:

Keratinocytes
Langerhans cells
Melanocytes
Merkel cells

Based on epidermis layer skin divided into 2 class:

Thick skin:

soles of feet, palms of hands

5 layer of epidermis

Thin skin

Most skin
4 layer of epidermis

Dermis (Corium)

The layer of skin immediately deep to the

epidermis
Divided into two layers

papillary layer
reticular layer

Contains all the cells of connective tissue proper

Accessory organs :hair follicles and sweat glands,
Networks of blood vessels, lymph vessels, and
nerve fibers

Hypodermis

Not a part of skin

Mostly adipose tissue

(some areolar)
Obesity due to
accumulation of
subcutaneous fat
About 8% thicker in
women than men
Functions:
Binds skin to underlying
tissue
Energy reservoir (fat)
Thermal insulation
Padding/cushioning

Skins Defense System

Inherent
Skin Immune System

Inherent (Non-immune) Skin Defenses

Physical

Resistance to mechanical trauma

Relatively water impermeable
Physical separation between self and nonself

Chemical

Free fatty acids

Free radical trapping
Antimicrobial peptides

Inherent Skin Defenses (contd)

Photoprotective

Melanin as a UV chromophore

Injury repair

Microbiological

Sebum production

Home for colonizing, nonpathogenic bacteria

that:

Compete for nutrients

Compete for attachment
Produce antibacterial substances

Skin Immune System

Components
1. Cells: APCs, Phagocytes, lymphocytes,
endothelial cells, keratinocytes
2. Humoral components
3. Draining regional lymph vessels and nodes

Innate Immune Features of the Skin

No specialization for skin

Cellular component

Phagocytes: Macrophages, neutrophils, NK cells

Mast cells

Humoral:

Complement
Cytokines, histamine

Cells of the Cutaneous Adaptive Immune Response

Langerhans cell
Dermal dendrocytes
Keratinocytes
T-cells
Endothelial cells
B-cells
T-cells)

Some cellular components of the skin immune

system

Keratinocytes

Prime role

make the protective horny layer

support to the outermost epithelium of the body
immunological functions
Produce large numbers of cytokines
Can be induced by -interferon to express HLA-DR

Produce -melanocyte-stimulating hormone

immunosuppressive.

Upregulate ICAM-1

Expressed MHC II present antigen

Healing in epidermal injury

Cytokines produce by kertainocytes

Langerhans cells

Bone marrow-derived, Dendritic-shaped cell,

Birbeck granules
Migration and maturation
Bone marrow Blood (M) Epidermis (LC/
Langerhans cells)
Afferent lymph (VC/ veiled cells) Lymph node
(FDC/ Follicular dendritic cells)

Functions

Antigen capture and processing

Presentation of antigen
Potent co-stimulator of nave T-cells
Produce activating cytokines

Langerhans cells

Dermal dendritic cells

poorly characterized cells

found around the tiny blood vessels of the
papillary dermis.
MHC Class II antigens
probably function as antigen presenting cells

Mast cells

present in most connective tissues,

predominantly around blood vessels
granules contain inflammatory mediators

Stimuli:
Immunologic : IgE binding antigen
Nonimmunologic: Physical, drugs,
complement

Mast Cells

Endothelial Cells

Increase permeability

When activated, endothelial cells

cell surface expression of P and E-selectin

enhanced leukocyte margination

expression of VCAM-1 & ICAM-1 stop leukocytes

and allow diapedesis

Immune response amplified

 T-Cells

Intraepidermal lymphocytes
Resident in epithelia; do not recirculate
Restricted TCR
Presence and function in human skin are still
controversial
May play a role in combating antigens that
enter through the skin

Another cells types:

T lymphocytes

T-helper (TH)/inducer cells

T-cytotoxic (TC) cells

L cells/null (non-T, non-B) cells

Natural killer cells

Antigens and haptens

Superantigens
Antibodies (immunoglobulins)
Cytokines
Adhesion molecules

Molecular components of the skin

immune system

Cellular adhesion molecules (CAMs)

Histocompatibility antigens

Response Patterns of the Skin

Immune System

Example...

Skin immunopathology
Mechanism

Viral infection

Disease

Varicella /herpes
zoster
HSV1 & HSV2
Type IV
Tuberculin test
hypersensitivity Contact dermatitis
Type I
Urtikaria (wheal and
Hypersensitivity flare)
Bacterial
M. Leprae
infection
(intracellular)
Staphylococcal
infection

Immune
components
involved
Class I MHC
molecules
Cytotoxic T cell
Cell mediated
immunity
Mast cell, Th2, IgE
Th1 & Th2
response
Antibody, Th2,
complement

The keratinocyte and wound healing

T-lymphocyte activation

Type I: immediate hypersensitivity reactions

Urticaria: an immediate (type I) hypersensitivity reaction

Type II: humoral cytotoxic reactions

Bullous pemphigoid; a humoral cytotoxic (type II) reaction against a basement

membrane zone antigen.

Type III: immune complex-mediated reactions

Immune complex-mediated vasculitis (type III reaction)

Type IV: cell-mediated immune reactions

Induction phase of allergic

Elicitation phase of allergic

contact dermatitis

contact dermatitis

Response to intracellular antigens

Intracellular fungi or viruses and tumour

antigens

presented to cytotoxic T cells (CD8+) by the

MHC Class I molecule to destruction by
cytotoxic T lymphocytes or K cells.

Summary...

Further readings

Skin Immune System; Cutaneous Immunology

and Clinical Immunodermatology Third Edition
Clinical Dermatology